Provider Demographics
NPI:1528175353
Name:LAUREL HOMECARE SERVICES INC
Entity type:Organization
Organization Name:LAUREL HOMECARE SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRES
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:RODGERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:856-451-1711
Mailing Address - Street 1:62 S LAUREL ST
Mailing Address - Street 2:
Mailing Address - City:BRIDGETON
Mailing Address - State:NJ
Mailing Address - Zip Code:08302-1945
Mailing Address - Country:US
Mailing Address - Phone:856-451-1711
Mailing Address - Fax:856-451-1409
Practice Address - Street 1:62 S LAUREL ST
Practice Address - Street 2:
Practice Address - City:BRIDGETON
Practice Address - State:NJ
Practice Address - Zip Code:08302-1945
Practice Address - Country:US
Practice Address - Phone:856-451-1711
Practice Address - Fax:856-451-1409
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-25
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0108502Medicaid
NJ0002735000OtherAMERIHEALTH INS
NJ0333380001Medicare ID - Type Unspecified